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Food SelectionNCT06648226

Food Swaps to Improve the Healthfulness and Reduce the Carbon Footprint of Grocery Purchases

A study testing Health swaps, Climate swaps and Combined health and climate swaps in people with Food Selection and Nutrition, run by Stanford University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The study aims to determine whether viewing health or climate labels (or both) and receiving recommendations for healthier or more climate-friendly swaps (or both) in an online grocery store environment improves the healthfulness and reduces the carbon footprint of consumers' food and beverage purchases compared to… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Food Selection, Nutrition, Food Preferences
What is being tested?
Health swaps, Climate swaps and Combined health and climate swaps
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,201 participants
Where
1 siteUnited States
Study dates
7 May 2025to 25 Jun 2025
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Aged 18 years or older
  • Reside in the United States
  • Able to complete a survey in English
  • Have internet access to complete the 3 online study visits

Who cannot join

  • Under the age of 18
  • Reside outside of the United States
  • Unable to complete a survey in English
  • Do not have internet access to complete the 3 online study visits

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Stanford School of Medicine

    Palo Alto, California, 94304

Other trials in United States

About this study

Official title: A Randomized Trial of Food Swaps to Improve the Healthfulness and Reduce the Carbon Footprint of Grocery Purchases

The study aims to determine whether viewing health or climate labels (or both) and receiving recommendations for healthier or more climate-friendly swaps (or both) in an online grocery store environment improves the healthfulness and reduces the carbon footprint of consumers' food and beverage purchases compared to shopping as usual without swap recommendations. The online store will record participants' food selections. Participants will also be asked to complete survey measures.

Read the detailed description

Participants will complete an online between-subjects randomized experiment. The experiment will involve three study visits.

In the first study visit, participants will complete an online grocery store shopping task without intervention. Participants will be given a budget of $50 and asked to shop as they normally would. The store will record participants' food selections. After completing the shopping task, participants will complete an online survey.

Approximately one week later, participants will complete a second study visit with the same instructions. They will be randomized to 1 of 4 conditions (1) health only, 2) climate only, 3) combined health and climate, 4) control. In the health only condition, participants will view labels with nutrition grades and may be directed to swap their selections for healthier items. In the climate only condition, participants will view labels with climate grades and may be directed to swap their selections for more climate-friendly (lower-carbon-footprint) items. In the combined health and climate condition, participants will view labels with health and climate grades and may be directed to swap their selections for healthier or more climate-friendly items. In the control group, participants will not view any labels or swaps. The store will record participants' selections. After completing the shopping task, participants will complete an online survey.

In the third study visit, the participants will maintain their assigned group and will be asked to repeat the same tasks as in the second visit.

Being tested
Health swaps, Climate swaps, Combined health and climate swaps, Control
Keywords
food choices, climate, dietary substitutions, diet
Medical subject headings
Food Preferences, Feeding Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Health swapsBehavioural

    Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).

  • Climate swapsBehavioural

    Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).

  • Combined health and climate swapsBehavioural

    Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.

  • ControlBehavioural

    Participants will not view any extra labels or be offered any swaps in the online grocery store.

Study groups in NCT06648226
Study groupRoleWhat they receive
Health swapsExperimentalLabels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Receives: Behavioral: Health swaps
Climate swapsExperimentalLabels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Receives: Behavioral: Climate swaps
Combined health and climate swapsExperimentalLabels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Receives: Behavioral: Combined health and climate swaps
ControlActive comparatorNo labels or swaps.
Receives: Behavioral: Control

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Healthfulness of Product Selection

    The study will asses healthfulness of participants' selections as the average Ofcom Nutrient Profiling Model score of the products the participants select in the shopping task. The score ranges from 0 to 100, where higher scores are healthier. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  2. Carbon Footprint of Participants' Grocery Store Selections

    The study will assess the carbon footprint of participants' selections, operationalized as the average carbon footprint (in CO2-equivalents) of the products the participants select in the shopping task. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, the non-missing value was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

Secondary outcomes (16)
  1. Calorie Density of Participants' Grocery Selections

    The study will assess the average calorie density of participants' grocery selections, calculated as the average kcal per 100g of the selected products. Higher values will indicate higher calorie density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  2. Sugar Density of Participants' Grocery Selections

    The study will assess the average sugar density of participants' grocery selections, calculated as the average grams of sugar per 100g of the selected products. Higher values will indicate higher sugar density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  3. Sodium Density of Participants' Grocery Selections

    The study will assess the average sodium density of participants' grocery selections, calculated as the average milligrams of sodium per 100g of the selected products. Higher values will indicate higher sodium density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  4. Saturated Fat Density of Participants' Grocery Selections

    The study will assess the average saturated fat density of participants' grocery selections, calculated as the average grams of saturated fat per 100g of the selected products. Higher values will indicate higher saturated fat density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  5. Fiber Density of Participants' Grocery Selections

    The study will assess the average fiber density of participants' grocery selections, calculated as the average grams of fiber per 100g of the selected products. Higher values will indicate higher fiber density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  6. Protein Density of Participants' Grocery Selections

    The study will assess the average protein density of participants' grocery selections, calculated as the average grams of protein per 100g of the selected products. Higher values will indicate higher protein density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  7. Total Spending on Participants' Grocery Selections

    The study will assess the total amount participants spent on their grocery selections in United States dollars. Higher values will indicate greater spending. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  8. Thinking About Health

    The study will assess thinking about health using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... health." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  9. Thinking About Climate Impact

    The study will assess thinking about climate impact using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... climate impact." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  10. Thinking About Taste

    The study will assess thinking about taste using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... taste." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  11. Negative Emotional Reactions While Shopping

    The study will assess negative emotional reactions using 3 items: "While you were shopping, how much did you feel…" "worried", "guilty," "ashamed"? Response options range from "Not at all" (1) to "Extremely" (5). The investigators will average the 3 items; higher average scores indicate stronger negative emotional reactions. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  12. Positive Emotional Reactions While Shopping

    The study will assess positive emotional reactions using 3 items: "While you were shopping, how much did you feel…" "inspired", "proud," "reassured"? Response options range from "Not at all" (1) to "Extremely" (5). The investigators will average the 3 items; higher average scores indicate stronger positive emotional reactions. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  13. Injunctive Norms to Buy Healthy Foods

    The study will assess injunctive norms to buy healthy foods with 1 item: "People who are important to me think I should buy healthy foods." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  14. Descriptive Norms to Buy Healthy Foods

    The study will assess descriptive norms to buy healthy foods with 1 item: "Most shoppers buy healthy foods when they are shopping for groceries." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  15. Injunctive Norms to Buy Foods With Low Climate Impact

    The study will assess injunctive norms to buy foods with low climate impact with 1 item: "People who are important to me think I should buy foods with low climate impact." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

  16. Descriptive Norms to Buy Foods With Low Climate Impact

    The study will assess descriptive norms to buy foods with lower climate impact with 1 item: "Most shoppers buy foods with low climate impact when they are shopping for groceries." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.

    Measured: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Oct 2024
  2. Study start7 May 2025
  3. Primary completion25 Jun 2025
  4. Study completion25 Jun 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,201 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06648226
Sponsor's protocol ID
76925
Other IDs
K01HL158608
Status last verified
May 2026
First submitted
16 Oct 2024
Last updated
24 Jun 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The investigators will post the data to a public repository.

Questions about this trial

What is this clinical trial studying?

A study testing Health swaps, Climate swaps and Combined health and climate swaps in people with Food Selection and Nutrition, run by Stanford University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Jun 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Healthfulness of Product Selection (time frame: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jun 2026.

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